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Volume 23 Supplement 2

London Trauma Conference 2014

Anaesthesiologist-provided pre-hospital advanced airway management in children


Pre-hospital advanced airway management has been named one of the top-five research priorities in physician-provided pre-hospital critical care [1]. Few studies have been made on paediatric pre-hospital advanced airway management. The aim of this study was to investigate first-pass success rates and complications related to pre-hospital advanced airway management in patients younger than 16 years of age treated by pre-hospital critical care teams in the Central Denmark Region (1.3 million inhabitants).


A prospective descriptive study based on data collected from eight anaesthesiologist-staffed pre-hospital critical care teams between February 1st 2011 and November 1st 2012.


Of a total of 25 000 pre-hospital critical care missions, the pre-hospital critical care anaesthesiologists attempted endotracheal intubation in 25 children, 13 of which were less than 2 years old.

In one patient, a neonate (600g birth weight), endotracheal intubation failed. The patient was managed by uneventful bag-mask ventilation.

All other children had their tracheas successfully intubated by the pre-hospital critical care anaesthesiologists.

Over-all first pass success-rate was 75.0 %. In the group of patients younger than 2 years old, first pass success-rate was 53.8 %.

The overall rate of airway management related complications was 20 % in children younger than 16 years of age and 38 % in children younger than 2 years of age (n=13). No deaths, cardiac arrests or severe bradycardia (heart rate <60) occurred in relation to pre-hospital advanced airway management.


Compared to the adult population [2] the overall first-pass success rate is low. The complication rates (hypoxia, hypotension, aspiration and oesophageal intubations) in the paediatric population are higher than previously described in our pre-hospital advanced airway management patient population as a whole [2]. This illustrates that young children may represent a substantial pre-hospital airway management challenge even for experienced pre-hospital critical care anaesthesiologists.


  1. 1.

    Fevang E, et al: The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration. Scand J Trauma Resusc Emerg Med. 2011, 19: 57-10.1186/1757-7241-19-57.

  2. 2.

    Rognas L, et al: Pre-hospital advanced airway management by experienced anaesthesiologists: a prospective descriptive study. Scand J Trauma Resusc Emerg Med. 2013, 21: 58-10.1186/1757-7241-21-58.

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Correspondence to M Tarpgaard.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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  • Birth Weight
  • Cardiac Arrest
  • Endotracheal Intubation
  • Airway Management
  • Related Complication